Global Journeys - Student Educational Travel

On-Line Application Form for Summer Programs

Student Information

Last Name:

First Name:

Male Female

Date of Birth (DD/MM/YY):

Home Address (Number & Street):

Apt/Unit #:

City and Province/State:

Country:

Postal Code:

Home Phone:

e-mail:

Special Needs

Dietary Needs:

Do you have a medical history or use any medications of which we should be informed:

yes no

If yes please explain:

Please identify any special education needs:

Academic Information

Present School:

School Board:

School Address:

Phone #:

Counsellor/Advisor:

Course Selection

Course Year
2010
2011

Please check first choice

Greece & Italy

Classical Civilization, Grade 12, LVV4U

Philosophy: Questions And Theories, Grade 12, HZT4U

Math, Advanced Functions, Grade 12, MHF4U

English, Grade 12, ENG4U

Italy

English, Grade 12, ENG4U

Studies in Literature, Grade 12, ETS4U

Europe and the Arts, Interdisciplinary Course, Grade 12, IDC4U

Italian: Introductory, Level 1/Intermediate Level 2, LBAAD/LBABD

Italian: Level 3, LBACU

New Zealand & Australia

Biology, Grade 11, SBI3U

Biology, Grade 12, SBI4U

Environment And Resource Management Grade 12, CGR4M

English, Grade 12, ENG4U

Exercise Science, Grade 12, PSE4U

Earth and Space Science, Grade 12, SES4U

England, Scotland & Ireland

English, Grade 11, ENG3U

English, Grade 12, ENG4U

Mathematics of Data Management, Grade 12, MDM4U

World History, Grade 12, The West And The World CHY4U

France

World History, Grade 12, The West And The World CHY4U

Europe and the Arts, Interdisciplinary Course, Grade 12, IDC4U

World History to Sixteenth Century, Grade 11, CHW3M

Core French, Grade 11, FSF3U

Core French, Grade 12, FSF4U

French Immersion, Grade 11, FIF3U

French Immersion, Grade 12, FIF4U

French Extended, Grade 11, FEF3U

French Extended, Grade 12, FEF4U

Europe and the Arts

Europe and the Arts, Interdisciplinary Course, Grade 12, IDC4U

English, Grade 12, ENG4U

Philosophy: Questions And Theories, Grade 12, HZT4U

Ecuador & Peru

Biology, Grade 12, SBI4U

Canadian And World Issues: A Geographic Analysis Grade 12, CGW4U

Environment And Resource Management Grade 12, CGR4M

South America: The Land, The People, The Impact, Interdisciplinary Course, Grade 12, IDC4U

Southeast Asia

English, Grade 12, ENG4U

Canadian And World Issues: A Geographic Analysis Grade 12, CGW4U

Math, Advanced Functions, Grade 12, MHF4U

Challenge and Change in Society, Grade 12, HSB4M

International Business, Grade 12, BBB4M

Costa Rica July August

Biology, Grade 11, SBI3U

Biology, Grade 12, SBI4U

The Environment And Resource Management Grade 12, CGR4M

Challenge and Change in Society, Grade 12, HSB4M

Spanish, Intro/Intermediate Course, Grade 11 & 12

Bermuda

Biology, Grade 11, SBI3U

Biology, Grade 12, SBI4U

Marine Biology, Interdisciplinary Course, Grade 12, IDC4U

Environment And Resource Management Grade 12, CGR4M

The Grand Tour - August

English, Grade 12, ENG4U

International Business, Grade 12, BBB4M

Challenge and Change in Society, Grade 12, HSB4M

Math, Advanced Functions, Grade 12, MHF4U

Islands of Greece July August

Classical Civilization, Grade 12, LVV4U

Math, Advanced Functions, Grade 12, MHF4U

Ancient Civilizations - August

Classical Civilization, Grade 12, LVV4U

World Religions, Grade 11, HRT3M

English, Grade 12, ENG4U

English, Grade 11, ENG3U

Please indicate second choice:

Location:

Course:

I would like to room/class with

(if applicable and possible)

Parent/Guardian Information

Mother Salutation:
Last Name:
First Name:

Same address as child
Home Address:
Phone#: Business#:
email: Fax:#:

Father Salutation:
Last Name:
First Name:

Same address as child
Home Address:
Phone#: Business#:
email: Fax:#:

Name of legal guardian if applicable:

Payment

Comprehensive Travel Insurance
(optional but strongly recommended) $195 Bermuda/Cost Rica Online programs $295 All other programs

I will purchase the travel insurance:

yes

Once you submit your application, a Payment Form will be emailed to you and a staff member will contact you to confirm space and receipt of your application. A deposit of $1200 (cheque made payable to Global Journeys - STS Travel) or payment by credit card along with your $95 application fee and travel insurance fee, if applicable, will be required within 10 business days to reserve your space in the program. A letter of acceptance and further details will follow.

I would like to receive an invoice by:

Email

FAX

Post

I have read the Terms and Conditions and agree to these terms and conditions.